Study Design Details

Established on race/ethnicity and SES; not established on baseline measures of the outcomes.

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Notes:

In addition to the outcome that rated high, several outcomes in this study rated low: positive engagement at ages 3, 4, and 5; coercive engagement at ages 3, 4, and 5; and three measures of effortful control at age 5 (the wrapped-gift task, draw-a-star task, and tower task). These outcomes rated low because we could not assess attrition or baseline equivalence based on information reported in the study, nor was this information available from the author. HomVEE reports results for interventions delivered to families with children from birth to kindergarten entry. Given that the FCU intervention continued to be delivered to families at the time of later assessment, child and parent outcomes reported within this study that were assessed after children were age 5 were excluded from review. In addition, some outcomes in the structural equation models reported in this study were not eligible for review because the model did not estimate the direct, total effect of the intervention on the outcome. This study is part of a large RCT described by Dishion et al. (2008).

Study Characteristics

Study Participants

The study included 731 families that met two criteria. First, they participated in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) when their son or daughter was between 2 years 0 months old and 2 years 11 months old, and who also met the study’s criteria for being at risk for behavior problems—defined as one standard deviation or more above normative averages in at least two of three domains: (1) child behavior problems (for example, conduct problems or high-conflict relationships with adults); (2) primary caregiver problems (for example, maternal depression, daily parenting challenges, self-report of substance or mental health diagnosis, or status as a teen parent at first birth); and (3) socioeconomic status (low caregiver educational achievement or low family income based on WIC criteria). Screening was conducted in 2002 and 2003. Of the 731 primary caregivers who agreed to participate, 41 percent had a high school diploma or GED, 32 percent had one or two years of post-high school training, and 24 percent had less than a high school diploma or GED. More than two-thirds of the randomized sample had an annual income below $20,000. Of the 731 children in the study, 50 percent were European American, 28 percent were African American, 13 percent were biracial, and 9 percent were from another racial group. Thirteen percent were Hispanic. The children were 29.9 months old on average at the time of the age 2 assessments. Forty-nine percent of the children were female, and 58 percent lived in two-parent households.

Setting

Families were recruited from WIC program sites in and around Pittsburgh, Pennsylvania (37 percent of sample); Eugene, Oregon (37 percent of sample); and Charlottesville, Virginia (26 percent of sample).

Home Visiting Services

The Family Check-Up program typically involves three meetings; an initial contact meeting (a “get to know you” meeting); an assessment meeting during which families participate in a comprehensive assessment of child and family functioning; and a feedback meeting to discuss the results of the assessment. After the feedback meeting, families can choose to participate in additional follow-up meetings. For this study, the order of the meetings was changed. All families participating in the study were given the comprehensive assessment. The researchers then randomized families into intervention and comparison groups. Following randomization, families in the intervention group participated in the initial contact and feedback meetings, which were led by parent consultants. These consultants discussed family issues and family functioning during the initial contact meeting and, during the feedback meeting, used motivational interviewing techniques to discuss the results of the assessment, areas of strength, areas for improvement, and recommended services that might help the family. After the feedback meetings, families could choose to participate in additional follow-up meetings. Families assigned to the intervention group received the intervention once yearly when their children were 2, 3, 4, and 5 years old.

Comparison Condition

Families in the comparison group received the Family Check-Up intervention's comprehensive assessment but did not receive any other interventions or services.

Staff Characteristics and Training

Parent consultants for this study had either a master’s or doctorate degree; had previous experience conducting family-based interventions; and were of diverse ethnicities, including Latino, African American, European American, and mixed ethnicity. Consultants were trained for two-and-a-half to three months in strategies that included didactic instruction and role-playing, as well as ongoing videotaped supervision of intervention activity. Consultants were certified by lead parent consultants at each site; the lead consultants were certified by a member of the research team. Certification was repeated annually and was established by reviewing videotapes of feedback and follow-up sessions. Weekly conference calls were held to discuss cases, and annual consultant meetings were held to update training, discuss possible changes in the intervention, and address issues related to families’ needs.

Funding Source

National Institute on Drug Abuse grants 023245 and 2003723 to Shelleby, Dishion, and Wilson.

Author Affiliation

The authors are associated with Sungkyunkwan University, the University of Pittsburgh, Northern Illinois University, Arizona State University, and the University of Virginia. In addition, Thomas Dishion, a study author, is a developer of this program model.